Nursing Elites

1. Which substance would most likely need to be restricted in patients with heart failure who use diuretics to help reduce fluid retention?

• A. potassium
• B. magnesium
• C. sodium
• D. chloride

Correct answer: C

Rationale: Sodium restriction is crucial in heart failure management to prevent fluid retention, which can worsen symptoms of heart failure.

2. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

• A. Providing a straw for consumption of liquids
• B. Encouraging larger bites
• C. Placing the client in semi-Fowler's position during meals
• D. Instructing the client to tilt head forward when swallowing

Correct answer: C

Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.

3. A nurse is caring for a client who has a new prescription for a low-sodium diet. The client's family has requested to bring in some of the client's favorite foods. Which of the following food items should the nurse tell the family members to omit?

• A. Boiled rice
• B. Flat bread
• C. Broiled fish fillet
• D. Pickled vegetables

Correct answer: D

Rationale: The correct answer is 'Pickled vegetables.' Pickled vegetables are high in sodium due to the pickling process, making them unsuitable for a low-sodium diet. Boiled rice, flat bread, and broiled fish fillet are generally lower in sodium compared to pickled vegetables and can be included in a low-sodium diet. Therefore, the nurse should advise the family to omit pickled vegetables to adhere to the client's dietary restrictions.

4. A Hazard Analysis and Critical Control Points (HACCP) program would address which element of food service?

• A. cleaning and disinfecting of utensils
• B. developing healthy menus
• C. controlling patient calorie intake
• D. prescribing diets for patients with swallowing problems

Correct answer: A

Rationale: The correct answer is A. Hazard Analysis and Critical Control Points (HACCP) programs are designed to ensure food safety by identifying and controlling potential hazards. This includes addressing the cleaning and disinfecting of utensils to prevent contamination and maintain safe food handling practices. Choices B, C, and D are incorrect because HACCP primarily focuses on preventing food safety hazards rather than developing menus, controlling calorie intake, or prescribing diets for specific medical conditions.

5. A nurse is caring for a client with a thiamine deficiency. Which assessment findings will the nurse expect?

• A. Tachycardia, muscle weakness, and lack of coordination
• B. Swollen lips, cracks in the corners of the mouth, and glossitis
• C. Neuropsychiatric symptoms of delusions and hallucinations
• D. Scaly rash on arms, dementia, and diarrhea

Correct answer: A

Rationale: Thiamine deficiency, also known as Vitamin B1 deficiency, can present with various symptoms. Tachycardia, muscle weakness, and lack of coordination are classic signs of thiamine deficiency due to its role in energy metabolism. Swollen lips, cracks in the corners of the mouth, and glossitis are more indicative of a deficiency in riboflavin (Vitamin B2). Neuropsychiatric symptoms of delusions and hallucinations are characteristic of niacin (Vitamin B3) deficiency. A scaly rash on the arms, dementia, and diarrhea are not typically associated with thiamine deficiency. Therefore, the correct assessment findings for a client with thiamine deficiency are tachycardia, muscle weakness, and lack of coordination.

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